心脑血管病防治2026，Vol.26Issue(2)：16-20,5.DOI:10.3969/j.issn.1009-816x.2026.02.004
血清MCP-1、HIF-1α、VEGF和ET-1在动脉瘤性蛛网膜下腔出血患者脑血管痉挛及预后中的临床价值
Clinical value of serum MCP-1,HIF-1α,VEGF,and ET-1 in cerebral vasospasm and prognosis of patients with aneurysmal subarachnoid hemorrhage
摘要
Abstract
Objective To explore the clinical value of monocyte chemoattractant protein-1(MCP-1),hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and endothelin-1(ET-1)in cerebral vasospasm(CVS)and prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods A retrospective analysis was conducted on the clinical data of 120 aSAH patients admitted to the Department of Neurosurgery,Zigong Fourth People's Hospital from January 2020 to December 2023.MCP-1,HIF-1α,VEGF,and ET-1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Patients were divided into two groups according to the occurrence of in-hospital CVS:the CVS group(84 cases)and the pure aSAH group(36 cases).Clinical characteristics and laboratory indicators of the two groups were compared.Regular follow-up was conducted.Patients in the CVS group were further divided into a poor prognosis group(34 cases)and a good prognosis group(50 cases)based on their prognosis.Clinical characteristics and laboratory indicators were compared between aSAH patients with CVS who had different prognoses.Influencing factors for the poor prognosis in aSAH patients with CVS were analyzed by a multivariate Logistic regression model,and the predictive efficacy of serum MCP-1,HIF-1α,VEGF,and ET-1 for the prognosis of aSAH patients with CVS was analyzed by receiver operating characteristic(ROC)curve.Results The CVS group had higher intracerebral hemorrhage volume and MCP-1,HIF-1α,VEGF,and ET-1 levels compared to the pure aSAH group(t=4.732,12.169,20.220,15.984,13.371;P<0.05),and a lower Glasgow Coma Scale(GCS)score(t=2.079,P<0.05).In aSAH patients with CVS,the poor prognosis group had higher intracerebral hemorrhage volume,and serum levels of MCP-1,HIF-1α,VEGF,and ET-1 compared to the good prognosis group(t=16.812,13.664,5.728,6.868,11.161;P<0.05),and a lower GCS score(t=11.423,P<0.05).There was a statistically significant difference in Fisher grade between the two groups(χ2=20.403,P<0.05).Logistic regression showed that serum MCP-1(OR=1.758),HIF-1α(OR=1.740),VEGF(OR=1.539),ET-1(OR=1.799),and Fisher grade 3(OR=1.379)and grade 4(OR=1.483)were risk factors for poor prognosis in aSAH patients with CVS,while GCS score(OR=0.695)was a protective factor(P<0.05).ROC curve analysis showed that the combined prediction of serum MCP-1,HIF-1α,VEGF,and ET-1 for the prognosis of aSAH patients with CVS had a sensitivity of 86.45%and a specificity of 94.67%,with an area under the curve(AUC)of 0.927,which was higher than the diagnostic value of each biomarker alone(Z=5.378,5.674,6.121,4.876;P<0.05).Conclusion Serum MCP-1,HIF-1α,VEGF,and ET-1 are highly expressed in aSAH patients with CVS and poor prognosis.Combined detection has a high predictive efficacy for the poor prognosis in aSAH patients with CVS.关键词
颅内动脉瘤/蛛网膜下腔出血/脑血管痉挛/单核细胞趋化蛋白-1/缺氧诱导因子-1α/血管内皮生长因子/内皮素-1Key words
Intracranial aneurysm/Subarachnoid hemorrhage/Cerebral vasospasm/Monocyte chemoattractant protein-1/Hypoxia-inducible factor-1α/Vascular endothelial growth factor/Endothelin-1引用本文复制引用
杨呈浩,蓝美锐,罗飞,陈曦,邓云良..血清MCP-1、HIF-1α、VEGF和ET-1在动脉瘤性蛛网膜下腔出血患者脑血管痉挛及预后中的临床价值[J].心脑血管病防治,2026,26(2):16-20,5.基金项目
四州省医学(青年创新)科研课题(S19070) （青年创新）
